WO2011131159A1 - Ensemble et procédé pour la fabrication d'au moins un alésage de guidage dans un gabarit de perçage - Google Patents

Ensemble et procédé pour la fabrication d'au moins un alésage de guidage dans un gabarit de perçage Download PDF

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Publication number
WO2011131159A1
WO2011131159A1 PCT/DE2011/000056 DE2011000056W WO2011131159A1 WO 2011131159 A1 WO2011131159 A1 WO 2011131159A1 DE 2011000056 W DE2011000056 W DE 2011000056W WO 2011131159 A1 WO2011131159 A1 WO 2011131159A1
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WO
WIPO (PCT)
Prior art keywords
impression
template
denture
retainer
positive
Prior art date
Application number
PCT/DE2011/000056
Other languages
German (de)
English (en)
Inventor
Kai Gruber
Original Assignee
Jg Special Products Unternehmergesellschaft (Haftungsbeschränkt)
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
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Application filed by Jg Special Products Unternehmergesellschaft (Haftungsbeschränkt) filed Critical Jg Special Products Unternehmergesellschaft (Haftungsbeschränkt)
Publication of WO2011131159A1 publication Critical patent/WO2011131159A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/082—Positioning or guiding, e.g. of drills
    • A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/12—Tools for fastening artificial teeth; Holders, clamps, or stands for artificial teeth

Definitions

  • the present invention relates to a set and a method for producing at least one guide bore in a surgical template, which is used by a dentist for preparing a jawbone for a medical implant.
  • a denture such as a dental prosthesis.
  • an artificial crown or bridge by attaching it to at least one bone integrated implant.
  • an elongated pin-like element made of a suitable material, such as an implant may be used as an implant. Titanium. After implantation, this element undergoes a process of integration into the jawbone and, after integration, can form a support for the dental prosthesis projecting from the surface of the gum surrounding the jawbone.
  • the pin-like element usually serves a trained by a drill in the jaw bone and tailored to the length and width dimensions of the implant implantation cavity. It is extremely important that the hole drilled in the bone tissue has a correct position and inclination in the thickness and morphology of the bone to avoid perforation of the proximal tooth root, the outer surface of the jawbone, the mandibular canal or the paranasal sinuses.
  • an implantologist typically uses a surgical template obtained from a plaster cast of the dentition or a 3-dimensional model of the denture that fits exactly on the patient's teeth and / or gums.
  • This drilling template is provided with a guide tion bore provided exactly in extension of the axis of the bore to be produced, in which guide bore finally a drill sleeve can be used to improve the guidance of the drill used during drilling and to prevent premature wear of the guide bore.
  • the surgical template can be placed on the patient's teeth and / or gums during subsequent surgery at the same position. This reduces the risk of accidental injury to critical anatomical structures that exists during free-hand drilling without a template.
  • the time required to make the template is considerable. Thus, it usually takes a few days between the first session, in which, for example, a jawbone of the patient is taken by means of a computer tomograph, and the insertion of the at least one implant. The reason for this is the need for the dentist or implantologist to work with a dental laboratory that manufactures the surgical template.
  • the position of the guide bore in the surgical template is determined by the implantologist based on his knowledge and practical experience, leaving room for error.
  • a method and a set for producing at least one guide hole in a surgical template which serves a dentist for preparing a jaw bone for a medical implant, provide, which makes it possible, the guide bore in the drilling template in a shorter time in a to provide a precise and reliable way.
  • this object is achieved by a set for producing at least one guide bore in a surgical template, which serves a dentist for preparing a jawbone for a medical implant, comprising a denture impression template, which has a plurality of geometrical fixed points.
  • a holding device for supporting a positive denture impression corresponding to the negative denture impression in a defined position
  • an alignment device for setting the defined position by aligning the positive denture impression supported in the holding device with respect to the denture impression template located in a predetermined position with the interposition of the negative denture impression located in the denture impression template
  • a processing device which is determined based on predetermined coordinates, which are determined using data acquired by the imaging method, for producing at least one guide bore in a Bohrschablone blank placed on the positive bit impression and adapted to the drilling template to form the drilling template.
  • the basic idea of the invention is the provision of equipment or a system of devices which makes it possible for a dentist or dental laboratory to automate the manual intermediate steps previously required in the production of the at least one guide bore such that a transmission of the predetermined coordinates which the implant Embodying positional data and based on the imaging technique commonly used in human medicine is made possible in a simple manner on a surgical template blank, without the need for special manual skills, in order to obtain a flawless surgical template.
  • the set may, for example, be assigned an image data acquisition device which is designed to record 2- or 3-dimensional image data regarding the arrangement of the jawbone and the geometric orientation of the bite impression template with respect to the jawbone by means of the imaging method.
  • a control device may also be provided which is adapted to determine the coordinates of the at least one guide bore and to control the processing device based on implant position data which is generated by means of a CAD planning software on the basis of the acquired image data Guide hole according to the given Bohrkoordinaten trains.
  • CT computed tomography
  • DVD digital volume tomography
  • the implant can be selected, for example, from a digital implant database in order to be able to optimally plan the guide bore necessary for inserting the implant based on the digital dimensions of the implant.
  • the denture impression template usually comprises a template body with a preferably approximately U-shaped recess for receiving an optionally solidifiable impression material for forming the negative denture impression, it should not be ruled out within the meaning of the invention that the denture impression template has a template body which is merely designed for this purpose is to cover one or more adjacent teeth, as occasion demands.
  • the geometric fixed points of the bite impression template are preferably made of spherical aluminum, zirconia or titanium elements, so as to ensure that the geometric fixed points, for example, at a scan using a CT are clearly visible.
  • three geometric fixed points are provided on the bite impression template, for example, five geometric fixed points can be provided on the bite impression template, of which two, relative to a longitudinally extending in the longitudinal direction of the bite impression template longitudinal axis of Bite impression template, are arranged in mirror image on opposite sides of the longitudinal axis, such that these four geometric fixed points are arranged together in a quadrangular configuration, and that the fifth of the geometric fixed points in the longitudinal direction of the longitudinal axis is offset by a predetermined distance from the other geometric fixed points, whereby In a 3-dimensional digital model also unfavorable views of the bite impression template - for example, if all fixed points are on a straight line, clearly represent and evaluate.
  • the bite impression template is provided with means for defined alignment or / and arranging or / and fixing the bite impression template with respect to the alignment device and / or the processing device.
  • These means comprise, for example, recesses provided on the dental impression template in the form of a plurality of guide bores of a predetermined diameter and predetermined positions, which can be brought into engagement with complementary projections or pins provided on the alignment device and / or the processing device, or at least one single recess a predetermined shape which is engageable with a correspondingly complementary projection provided on the alignment device and / or the processing device so as to fix the bit impression template with respect to the alignment device and / or the processing device in a predefined position and in a predetermined position can.
  • the holding device comprises a denture impression holding element, which is designed to releasably fix the positive denture impression, a holding device coupling element, which is adapted to couple the holding device in a defined position and orientation with a holding te Rheinsarnakopplungselement the alignment device and / or the processing device, and a retainer connecting member connecting the denture retainer member to the retainer coupling member, which is changed between a flexible condition in which the position of the denture retainer member with respect to the retainer coupling member can be changed and a rigid state in which the position of the denture retainer member with respect to the retainer coupling member can not be changed, is adjustable.
  • the denture impression holding element has at least three spaced-apart holding elements for fixing and supporting the positive denture impression, at least one of which being adjustable in position, preferably with respect to at least one other retaining element is displaceable, wherein at least the displaceable retaining element may be formed by a threaded bolt.
  • the at least three spaced-apart holding elements in the form of, for example, finger-shaped holding elements, which are pivotable about a common pivot around, it is inventively preferred if the Gebissabffyhalteelement has a plate-shaped element having one end with a possibly displaceably arranged in the longitudinal direction of the Gebissabyakhalteelements bearing element for supporting the threaded bolt is formed, and the other end is designed to support the other holding elements, wherein the longitudinal axis of the threaded bolt is preferably orthogonal to the longitudinal axes of the other holding elements.
  • the holding device connecting element has two rod-shaped elements, each of which at one end on a Gebissabdruckhalteelement possibly releasably and / or adjustable attached flange of Gebissabyakhalteelements and at its respective other end to a on the Halte Schauskopplungselement possibly solvable and / or adjustably mounted flange are mounted such that the rod-shaped elements together receive the two flanges between them, wherein a necessary for a determination of the rod-shaped elements on the two flanges clamping force is provided by at least one clamping element, preferably in the form of a threaded bolt, which with the two rod-shaped elements, for example in a lying between its two ends area is engaged.
  • a necessary for a determination of the rod-shaped elements on the two flanges clamping force is provided by at least one clamping element, preferably in the form of a threaded bolt, which with the two rod-shaped elements, for example in a lying between its two ends area is engaged.
  • elongated holes are formed in the flanges and that the two rod-shaped elements are provided at their respective ends with guide elements which are guided in the oblong holes and slidably mounted in these in the longitudinal direction of the slots are.
  • at least one of the guide elements of a preferably displaceable in its longitudinal direction and / or captive on at least one of the rod-shaped elements mounted guide pin may be formed, which connects the associated slot passing through the two rod-shaped elements.
  • the retainer coupling member preferably comprises a substantially tubular member having an axially extending longitudinal axis, the flange being provided at one axial end of the tubular member and the tubular member having a recess orthogonal to its longitudinal axis for receiving a retainer pin which serves to retainer retainer member in a defined position at a holding device counter coupling element of the alignment device and / or the processing device set.
  • the retaining bolt is mounted rotatably about its longitudinal axis on the tubular element and at least on one radial side in the region of an interior of the tubular element orthogonal to its longitudinal axis has a flattening or recess to provide a reduced diameter bolt cross-section.
  • the holding device counter coupling element comprises a cylindrical member whose outer dimensions substantially correspond to the inner dimensions of the Halter adoptedskopplungselements, said substantially cylindrical member orthogonal to a
  • the longitudinal axis thereof is provided with a circular recess for supporting the retaining bolt of the holder coupling element and with a connecting passage which extends in the longitudinal direction of the substantially cylindrical element from the recess to the die-pressure retaining element-side end, which together with the circular recess has a P formed holding pin receptacle, wherein the web formed by the connecting passage of the P orthogonal to the longitudinal axis of the cylindrical element s and to its direction of extension has a width which substantially corresponds to the width of the diameter-reduced cross section of the bolt orthogonal to the flattening or recess.
  • the machining device comprises a multi-axis drilling machine, in particular a 5-axis drilling machine, for forming the at least one guide bore in the drilling template blank, and that the machining device is provided with a holding device counter coupling element for coupling to a holding device coupling element of the holding device is.
  • the alignment device comprises a denture template holding element, which is designed to store the denture impression template in a defined position and orientation; a retainer counter coupling member for coupling to a retainer coupling member of the retainer; and an aligner adjustment member configured to position the retainer counterpart member in position relative to the bit impression template holding member at least between a first position in which the retainer counter member is a first distance away from the bit impression template holding member and a second position in which the retainer gene coupling member a predetermined second distance away from the denture template holding member, wherein the predetermined second distance is less than the first distance.
  • the alignment device adjustment element may comprise at least two guide rods connected to the retainer counter coupling element which are integral with the denture template retention member connected mecanicsstangenfact- element are guided.
  • the present invention further relates to a denture template for a kit, as previously described, which denture template has a plurality of geometric fixed points, which are detectable by means of an imaging technique commonly used in human medicine, and which is intended to form a negative denture impression at least a portion of a denture.
  • the present invention further relates to a holding device for a set, as described above, which holding device is designed to support a positive denture impression corresponding to a negative denture impression in a defined position.
  • the present invention further relates to an alignment device for a set, as described above, which alignment device is adapted to, in a holding device, which supports a corresponding with a negative denture impression positive dentition in a defined position, the defined position by aligning in a Holding device supported positive denture impression with respect to a present in a predetermined position Gebissabubaschablone with the interposition of a arranged in the Gebissabubaschablone negative denture impression.
  • a processing apparatus for a set as described above which processing apparatus is set based on predetermined coordinates determined using data acquired by an imaging process to produce at least one guide bore in one positive dental impression is applied and adapted to this adapted template blank to form a drilling template.
  • the above object is achieved by a method of manufacturing at least one guide bore in a surgical template, which a dentist uses to prepare a jawbone for a medical implant, which the steps comprises producing a negative denture impression of at least one part of a jaw by means of a denture impression template, which has a plurality of geometrical fixed points that can be detected by means of a biology method commonly used in human medicine; perform an imaging procedure while the denture template is applied to the patient's jaw to capture image data concerning the jawbone and the geometric fixation points of the denture template and thereby the location of the denture template with respect to the jawbone; to form a positive dentition impression; attach a retainer coupling member to the positive denture impression using an intermediate retainer connection member that is adjustable between a flexible state and a rigid state; attach the retainer coupling element and the bit impression template with the negative denture impression therein in a respective defined position; engage the positive denture impression with the negative denture impression while the retainer connector is in its flexible state; change
  • the predetermined coordinates may be obtained by creating a 3-dimensional digital model of at least a portion of the patient's jawbone, the 3-D digital model containing positional data of the plurality of geometric landmarks; the medical implant on the digital 3-dimensional len model and its position and orientation in the 3-dimensional model are digitally constructed; digitally construct a drill model based on the 3-D digital model and the digitally constructed implant; and the drilling model is transferred to the processing device.
  • the positive denture impression and template blank will be manufactured based on the 3-dimensional digital model.
  • a drill sleeve serving as a guide for a drill bit may be inserted into the guide bore formed in the surgical template so as to enhance the guidance of the drill when drilling the implant cavity in the patient's jawbone, without the risk in that, during the drilling process, the drill engages in the material of the drilling template, which would reduce the accuracy of the drilling.
  • the method may further comprise the steps of attaching the denture abutments with the negative denture therein to an alignment device; attaching the positive denture impression to the alignment device by coupling the retainer coupling element to a retainer retainer of the alignment device in a first position in which the retainer counterpart element is a first (any) distance away from the bit impression ablation; and then displace the retainer countermember together with the positive bit impression attached thereto to a second position in which the retainer counterpart element is a predetermined second distance from the bit impression template, the predetermined second distance being less than the first distance.
  • the digitally constructed drilling model is converted into vector data and that the vector data - taking into account all axes of the multi-axis drilling machine - are converted into the coordinate system of the multi-axis drilling machine ,
  • the converted vector data can then be used to calculate individual axis boring machine pathways that allow the multi-axis drilling machine to approach a corresponding start and end point of a vector and execute the guide bore according to location and orientation of the positive bit impression and the surgical template blank mounted thereon.
  • Figure 1 is a photographic representation of a drill bit template applied to a positive denture impression used as a drill template when drilling holes in a patient's jawbone;
  • FIG. 2 is a perspective view of a denture impression template
  • FIG. 3 shows a perspective view of a holding device for supporting a positive denture impression in a defined position
  • Fig. 4 is a plan view of the holding device of Fig. 3;
  • Fig. 5 is a left side view of the holding device of Fig. 3;
  • Fig. 6 is a front view of the holding device of Fig. 3;
  • Fig. 7 is a photograph of the holding device of Fig. 3 with a positive denture attached thereto; 8 shows a perspective view of the holding device of FIG. 3 with a positive denture impression shown in simplified form;
  • FIG. 9 shows a perspective view of an alignment device for setting a defined position of a positive denture impression inserted into the holding device of FIG. 3 with respect to the denture impression template;
  • FIG. 11 shows a photographic illustration of the alignment device with inserted holding device and inserted denture impression template in a first position of the alignment device, in which the positive denture impression is a first distance away from the denture impression template;
  • Fig. 12 is a perspective view of the alignment device in the first position of the alignment device, in which the positive denture impression is the first distance away from the denture impression template;
  • Fig. 13 is a perspective view of the alignment device of Fig. 10 in a second position of the alignment device in which the simplified, positive denture impression shown in simplification is engaged with the denture impression template;
  • 14 is an enlarged photograph of a portion of the alignment device illustrating the engagement of the positive denture impression with a negative denture impression located in the denture template.
  • 15 shows a perspective view of a processing device and an associated, but not yet coupled, holding device with a positive denture impression shown in simplified form;
  • Fig. 16 is a perspective view of the processing device and the associated holding device of Fig. 15 in the coupled state.
  • Fig. 1 shows a perspective view of a surgical template, generally designated 10, used in dental implantology during implantation of an implant hole in a patient's jawbone to allow accurate positioning and guidance of a surgeon's hand-guided drill.
  • the drilling template 10 consists essentially of a template body 12, preferably made of an acrylic resin material, which in the unprocessed state is considered a template blank in the sense of the invention and which in the present example is provided at a predetermined position with a drill sleeve 14 made of a metal, for example. which is inserted captive into a guide bore 16 in the template body 12.
  • the drilling template 10 serves as a guide for a drill, not shown, with which an implant hole, not shown, is to be drilled into a bone, in particular a jawbone, of a human or animal body. To allow accurate positioning of the drilling template 10, it is attached to the surface structure, i. adapted to the teeth and the gums of the patient, the environment of the implant hole to be introduced in the position of use, the drilling template 10 is disposed at the opening of the planned implant hole and fixed if necessary by additional measures immovable.
  • the set is associated with an image data acquisition device not shown, which serves, by means of a common in human medicine issuing method (computed tomography (CT), digital volume tomography (DVT) or similar method) 2- or 3-dimensional image data regarding the arrangement of the jawbone and the geometric orientation of the dental impression template 22 with respect to the jawbone, as well as associated with a control device which, based on implant position data, which are generated by means of a CAD planning software on the basis of the acquired image data, the coordinates of the determines at least one guide bore and controls the processing device so that it forms the guide bore according to the predetermined Bohrkoordinaten.
  • CT computed tomography
  • DVD digital volume tomography
  • control device which, based on implant position data, which are generated by means of a CAD planning software on the basis of the acquired image data, the coordinates of the determines at least one guide bore and controls the processing device so that it forms the guide bore according to the predetermined Bohrkoordinaten.
  • the denture impression template 22 consists essentially of a template body 32 with an approximately U-shaped recess 34 for receiving an optionally solidifiable impression compound 36, which is shown in Figures 10, 11 and 14 and which serves to form a negative denture impression 38.
  • the bit impression template 22 has a tapered grip part 40 at its front end.
  • a multiplicity of bores 42 are formed in the U-shaped recess 34, which essentially serve to better support the impression compound 36.
  • the denture template 22 has a plurality of geometric fixed points which can be detected by means of the imaging method.
  • Two geometric elements 30 made of aluminum, zirconia or titanium, for example, are used as geometric fixed points of the dental impression template 22 in FIG. 2, which are arranged at spaced-apart positions of the dental impression template 22 in respective receiving bores 44.
  • these spherical elements 30 are each two, based on a longitudinal axis A of the denture impression template 22 extending in the longitudinal direction of the denture impression template 22 is arranged mirror-inverted on opposite sides of the longitudinal axis A to form a quadrangle together, and the fifth of the geometric fixed points is offset in the longitudinal direction of the longitudinal axis A by a predetermined distance from the remaining geometric fixed points centrally (ie on the longitudinal axis A) in the transition region between the U-shaped recess 34 and the handle portion 40 is arranged.
  • the denture impression template 22 has two positioning bores 46 which are arranged mirror-inverted relative to the longitudinal axis A and serve for the defined alignment and / or arrangement and / or fixing of the denture impression template 22 with respect to the alignment device 26.
  • the denture impression template 22 additionally or alternatively on its bottom, not shown in the figures, have a depression which cooperates with a provided on the alignment means 26 projection 104, which will be discussed in more detail later.
  • an impression of the teeth around the area of the implant to be inserted ie a negative denture impression 38
  • a dental impression template 22 using a suitable impression material.
  • a surface scan of the affected jaw and the associated teeth is performed on the patient who required an implant by means of the conventional imaging technique (CT or DVT), wherein the patient receives the denture impression template 22 together with the negative denture impression 38 in the mouth. Since the geometrical fixed points of the denture impression template 22 can be detected by means of the imaging method, an exact assignment of the denture impression template 22 and the negative denture impression 38 located therein to the patient's jaw becomes possible. Based on The surface scan can be used to create a virtual 3-dimensional model that can be used to determine where dental implants should ideally be placed.
  • the thus produced positive denture impression 18 is then inserted into the above-mentioned holding device 24, which serves to support the positive denture impression in a well-defined position and orientation, which allows the processing device 28 in a later step, the guide bore 16 exactly and in to work the correct position in the template body 12.
  • the holding device 24 essentially consists of a denture impression holding element 48, which is designed to releasably fix the positive denture impression 18, a holding device coupling element 50, which is designed to hold the holding device 24 in a defined position and orientation with a retainer counter coupling element 52 of the alignment device 26 and / or the processing device 28, and a holding device connecting element 54 which connects the denture impression holding element 48 to the holding device coupling element 50 and which can be varied between a flexible state in which the position of the denture holding element 48 with respect to the holding device coupling element 50 can be changed , and a rigid state in which the position of the denture impression holding member 48 with respect to the Halteeinrich- tt coupling element 50 can not be changed, is adjustable.
  • the denture impression holding element 48 consists essentially of a plate-shaped element 56, which is connected by three threaded rods 58 with respect to the plate-shaped element 56 slidably disposed T-shaped bearing element 60, which serves storage element 60 for supporting a 48 adjustable in the longitudinal direction of the Gebißabdruckhalteelements threaded bolt 62.
  • two holding bolts 64 are arranged on the end of the plate-shaped element 56 which is at a distance from the bearing element 60 and serve together with the threaded bolt 62 for fixing and supporting the positive denture impression 18, the longitudinal axis of the threaded bolt 62 being orthogonal to the longitudinal axes of the two retaining bolts 64 , It goes without saying that not only the threaded bolt 62 but also the two bolts 64 can be made adjustable in their respective axial direction so as to enable a secure attachment of a wide variety of positively formed denture impressions 18.
  • the retainer connector 54 includes two rod-shaped members 66 and 68 which collectively receive at their respective upper end a flange 70 attached to the denture retainer 48 and are attached to the flange 70 by a bolt 72 passing through the flange and which are in common to their respective one bottom end receive a flange 74 attached to the Halte Schaupplungsele- element 50 between them and are mounted on the flange 74 by means of a bolt, not shown in the figures.
  • a clearly visible in particular in Fig. 5 bolt 76 which connects the two rod-shaped elements 66 and 68 in a region lying between its two ends, serves to one for a determination of the rod-shaped elements 66 and 68 on the two flanges 70 and 74 necessary Provide clamping force.
  • the bolt 72 may also serve to provide a clamping force necessary for defining the rod-shaped members 66 and 68 on the two flanges 70 and 74.
  • the retainer coupling member 50 is provided on its side facing the bit impression retaining member 48 with circumferentially spaced tapped holes 78 for receiving the flange 74 of the Gareriepplungselements 50 passing through threaded bolts 80 serve. It should be noted that corresponding threaded bores and associated threaded bolts can also be provided for connecting the flange 70 to the denture impression holding element 48.
  • the flanges 70 and 74 are provided with slots 82 and 84, wherein the bolt 72 passes through the slot 82 and the not shown bolt on Garlagens- coupling element-side end of the rod-shaped elements 66 and 68, the slot 84 passes.
  • the two rod-shaped elements 66 and 68 have at their respective ends only guide elements which engage in the slots 82 and 84 and are slidable in them in the longitudinal direction of the guide holes.
  • the retainer coupling member 50 includes a substantially tubular member 86 having an unspecified axially extending interior, one axial end of which is closed by the flange 74.
  • the tubular element 86 has, orthogonal to its longitudinal extension, a recess 88 for receiving a retaining bolt 90, which serves to hold the retaining device coupling element 50 (and thus the retaining device 24) in a defined position on the retaining device counter-coupling element 52 of the alignment device 26 or the machining device 28 festzule-
  • the retaining bolt 90 is rotatably mounted for this purpose about its longitudinal axis to the tubular member 86 and at least on a radial side in the region of an interior of the tubular member 86 orthogonal to its longitudinal axis provided with a flattening 87, whereby in this area a bolt cross-section is provided with reduced diameter.
  • the retainer counter-coupling member 52 comprises a cylindrical member 92 whose outer dimensions substantially correspond to the inner dimensions of the retainer coupling member 50, the substantially cylindrical member orthogonal to its longitudinal axis with a circular recess 94 for supporting the retainer pin 90 of the retainer coupling member 50 and with a is provided in the longitudinal direction of the substantially cylindrical member 92 from the recess 94 to the bite impression retainer-side end extending connecting passage 96, which forms a P-shaped retaining bolt receptacle together with the circular recess 94.
  • the connecting passage 96 i. the web of the P formed by the connecting passage orthogonal to the longitudinal direction of the cylindrical member 92 has a width substantially equal to the width of the reduced diameter cross section of the retaining bolt 90.
  • the alignment device 26 which allows the positive denture impression 18 supported in the holding device 24 exactly to the denture impression template 22 located in a predetermined position with the interposition of the denture impression template 22 negative Align denture impression 38.
  • the alignment device 26 has a denture impression Blonenhalteelement 98, which consists essentially of a U-shaped plate member 100, in whose upper side a U-shaped recess 102 is incorporated, which serves to receive the template body 32 of the denture impression template 22.
  • a projection 104 is arranged in the U-shaped depression 102, which projection cooperates with a recess provided on the underside of the denture impression template 22 and not shown in detail.
  • retaining pins may also be provided, which engage in the already mentioned positioning holes 46 of the denture impression template 22 in order to fix the denture impression template 22 in this way in a defined position and a defined orientation.
  • the retainer counter coupling element 52 of the alignment device 26 is fixed to a U-shaped plate member 106, which with the U-shaped plate member 100 via a.
  • Denture retainer displacement member 108 which serves to constrain retainer counteracting member 52 with denture retainer 48 mounted thereon at least between a first position in which retainer female member 52 is a first distance away from denture template retainer 98 and a second position; in which the retainer counterpart coupling element 52 is a predetermined second distance away from the bit impression clip retaining element 98, wherein the predetermined second distance, which is preferably 91 mm, is smaller than the first distance.
  • the adjustment of the dental impression holding element displacement element 98 between the two positions is made possible by two guide rods 110 connected to the U-shaped plate element 106, which are displaceably guided in a guide rod receiving element 112 mounted on the dental impression template holding element 98 in the longitudinal direction of the guide rods 110.
  • For fixing and adjusting the guide rod To facilitate the setting of the predetermined second distance is a fixedly arranged between the guide rods 110 stop member 116 which upon reaching the predetermined second distance at the bottom of the upper U-shaped plate member 116 is applied and thus prevents a further displacement of the U-shaped plate member 106 in the direction of the Gebissabdruckschablonenhal- teelement 98.
  • stop element 116 is designed to be displaceable parallel to the guide rods 110 and, for example, set or adjusted over a further, not shown in the drawings adjusting screw, so as to adjust different end stop positions, for example, depending on the used processing device or the holding device used.
  • the impression material 36 shown in FIGS. 10, 11 and 14, which forms the negative denture impression 38 and serves to align the positive denture impression in a precisely defined position with respect to the denture impression template 22, is included in FIG Figures 9, 12 and 13 is shown only in the form of a wedge-shaped projection 118 at the front end of the U-shaped recess 34, which provided with a at the front end of the Figures 9, 12 and 13 also shown in simplified form positive dent impression 18 recess 120th can intervene so as to represent in a highly simplified manner the engagement between the teeth formed on the positive denture impression 18 and the denture impression depressions formed in the negative denture impression 38.
  • the negative denture impression 38 of at least one first becomes Part of a jaw formed by means of the Gebissabdruckschablone 22, which has a plurality of geometric fixed points (spherical elements 30) which are detectable by means of the commonly used in human medicine imaging method, wherein the imaging process is performed while the Gebissabdruckschablone 22 on the jaw of the patient is applied to capture image data concerning the jawbone and the orientation of the bite impression template 22 with respect to the jawbone.
  • the positive dental impression 18 and the template body 12 serving as the template blank are produced.
  • the positive denture impression 18 thus generated is inserted into the holding device 24 and clamped back by means of the threaded bolt 62 and the front side by means of the retaining bolts 64 by tightening the rear threaded bolt 62.
  • the retainer 24 is inserted into the open alignment device 26 by moving the retainer pin 90 rearwardly, i.e., as shown in FIG. in the direction of the guide rods 110 to be facing flattening 87 is inserted into the connecting passage 96 of the holding device counter coupling element 52.
  • the retaining pin 90 is rotated by means of a corresponding tool such that the flattening faces upwards, that is to say toward the retainer counter-coupling element 52, so as to couple the retainer coupling element 50 and the retainer counter-coupling element 52.
  • the alignment device 26 is moved together to stop so as to set the predetermined second distance.
  • the bolts 72 and 76 which together push the two rod-shaped elements 66 and 68 against the flanges 70 and 74, are released and the clamped positive denture impression 18 carefully inserted into the negative denture impression 38 in the denture impression template 22 as detailed in FIG. 14 presented to the positive denture impression 18 aligned.
  • the alignment device 26 is opened by turning the adjusting screw 114 and the holding device coupling element 50 is released after unlocking the retaining pin 90 of the holding device counter coupling element 52 and the holding device 24 removed from the alignment device 26.
  • the template blank i.
  • the holding device 24 with the attached denture impression 18 and the applied template body 12 is inserted in a defined position into the processing device 28 shown in FIGS. 15 and 16 and coupled with the aid of a further holding device counter-coupling element 52 corresponding to the holding device counter-coupling element 52 of FIG Aligning means 26 is formed so as to place the positive bit impression 18 with stencil body 12 attached thereto in a predetermined and unique position, in which the processing device 28, which in the present case is a five-axis drilling machine 130, a drill 132 and a pivotable Protective hood 134 is capable of, based on the digitally constructed drilling model to incorporate the planned guide holes 16 in the template body 12.
  • This digital 3-dimensional model is used according to the invention not only to form the template body 12 and the positive denture impression 18, but also to construct the medical implant in the 3-dimensional model in digital form and the drilling model using the 3-dimensional digital model and the digitally constructed implant.
  • implant position data are generated by means of a CAD planning software on the basis of the acquired image data and the coordinates of the at least one guide bore are determined, these are transmitted to a control device (not shown) which stores the data of the digitally constructed drilling model in vector data and the vector data in Converting the coordinate system of the multi-axis drilling machine 130, taking into account all the axes and paths of the multi-axis drilling machine 130 and the processing device 28 such that it forms the at least one guide hole according to the predetermined Bohrkoordinaten, whereby the production of the guide hole is completed in the drilling template ,

Landscapes

  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Dental Prosthetics (AREA)

Abstract

L'invention concerne un procédé et un ensemble pour la fabrication d'au moins un alésage de guidage dans un gabarit de perçage, qui sert à un dentiste pour la préparation d'un os maxillaire pour un implant médical. L'ensemble comprend un gabarit d'empreinte dentaire (22), qui comprend une pluralité de points de repère géométriques (30) et qui forme une empreinte dentaire négative d'au moins une zone d'une dentition ; un dispositif de maintien (24) pour le support d'une empreinte dentaire positive (18) correspondant à l'empreinte dentaire négative à un emplacement défini ; un dispositif d'alignement (26) pour l'ajustement de l'emplacement défini par alignement de l'empreinte dentaire positive (18) supportée dans le dispositif de maintien (24) par rapport au gabarit d'empreinte dentaire (22) se trouvant à une position prédéterminée avec insertion de l'empreinte dentaire négative se trouvant dans le gabarit d'empreinte dentaire (22) ; et un dispositif de traitement, qui est destiné à la fabrication d'au moins un alésage de guidage dans une ébauche de gabarit de perçage placée sur l'empreinte dentaire positive (18) et adaptée à celle-ci pour former le gabarit de perçage, en se fondant sur des coordonnées prédéterminées, qui sont établies en utilisant des données recueillies au moyen d'un procédé d'imagerie.
PCT/DE2011/000056 2010-04-19 2011-01-20 Ensemble et procédé pour la fabrication d'au moins un alésage de guidage dans un gabarit de perçage WO2011131159A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE202010005857.0 2010-04-19
DE202010005857U DE202010005857U1 (de) 2010-04-19 2010-04-19 5-Achsen-Bohrmaschine, Referenztisch und Zahnabdruckschablonen zur Bearbeitung von Bohrschablonen, die vom Zahnarzt zum Setzen (Bohren) von Implantatstiften genutzt wird

Publications (1)

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WO2011131159A1 true WO2011131159A1 (fr) 2011-10-27

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DE (1) DE202010005857U1 (fr)
WO (1) WO2011131159A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2495730A (en) * 2011-10-17 2013-04-24 Digital Srl Dental imaging and moulding for a drill guide

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060281043A1 (en) * 2005-06-10 2006-12-14 Huffman Ronald E Dental modeling assembly and methods
WO2009135513A1 (fr) * 2008-05-09 2009-11-12 Ady Palti Dispositif d'usinage pour la réalisation d'un gabarit de forage destiné à des implants dentaires

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060281043A1 (en) * 2005-06-10 2006-12-14 Huffman Ronald E Dental modeling assembly and methods
WO2009135513A1 (fr) * 2008-05-09 2009-11-12 Ady Palti Dispositif d'usinage pour la réalisation d'un gabarit de forage destiné à des implants dentaires

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2495730A (en) * 2011-10-17 2013-04-24 Digital Srl Dental imaging and moulding for a drill guide

Also Published As

Publication number Publication date
DE202010005857U1 (de) 2010-08-26

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